Health Services Research Commons^™

The Role Of The Community Health Delivery System In The Health And Well-Being Of Justice-Involved Women: A Narrative Review, Sharla A. Smith, Glen P. Mays, Tracie C. Collins, Megha Ramaswamy

Health Management and Policy Faculty Publications

Background: Over seven million imprisoned and jailed women are released into the community each year and many are ill-equipped to meet the challenges of re-integration. Upon release into their community, women are faced with uncertain barriers and challenges using community services to improve their health and well-being and reuniting with families. Few studies have identified and described the barriers of the community health delivery system (CHDS)- a complex set of social, justice, and healthcare organizations that provide community services aimed to improve the health and well-being (i.e. safety, health, the success of integration, and life satisfaction) of justice-involved women. We …

Clinic Exploration Of Care Processes To Promote Colorectal Cancer Screening In Rural Accountable Care Organization Clinics: A Qualitative Case Study, Sarbinaz Bekmuratova, Jungyoon Kim, Hongmei Wang, Lufei Young, Daniel J. Schober, Li-Wu Chen

The Qualitative Report

It is essential to have an effective care process to promote colorectal cancer (CRC) screening particularly in rural areas. Primary care health care providers may have a significant impact on improving CRC screening rates among rural residents through systematic screening processes in their clinics. In this qualitative study, we aimed to explore the whole clinic processes of recommending and referring CRC screening in the rural accountable care organization (ACO) primary care clinics. We collected qualitative data through 21 semi-structured in-depth interviews with healthcare providers in rural primary care ACO clinics in Nebraska. We audio recorded and transcribed the interviews and …

Involvement Of Adults Who Are Deaf Or Hard Of Hearing In Ehdi Programs, Elizabeth Shuler-Krause, Karl R. White

Journal of Early Hearing Detection and Intervention

Consistent with a position statement of the Joint Committee on Infant Hearing (JCIH, 2007), several key organizations and groups have supported involving deaf and hard of hearing (DHH) adults in Early Hearing Detection and Intervention (EHDI) systems, including providing families of children who are DHH with opportunities to interact with adults who are DHH. This article reviews the available data on the involvement of adults who are DHH in EHDI systems to determine the availability of opportunities for families who have children who are DHH to interact with adults who are DHH, how families feel about these experiences, and to …

Family Impact Of Pediatric Hearing Loss: Findings From Parent Interviews And A Parent Support Group, Kristen L. Haddad, Wendy W. Steuerwald, Lori Garland

Journal of Early Hearing Detection and Intervention

Parents experience numerous stressors tied to their child's diagnosis as deaf or hard of hearing (DHH). This study sought to inquire about the lived experiences of parents with children who are DHH to inform the types of supports that should be provided within an audiology care coordination system. Semi-structured phone interviews were conducted with parents of children under the age of five who are DHH and patients of the Division of Audiology at Cincinnati Children’s Hospital Medical Center (CCHMC). Interview findings informed focus group questions, which were facilitated in a parent support group with parents of children who are DHH …

Comorbidities And Medication Adherence Among Older Individuals Living With Hiv In The United States, Amanda M. Kong

Dissertations and Theses

The number of people living with HIV (PLWH) ≥65 years old is increasing in the United States (US) as PLWH live longer. In 2015, there were nearly 1 million people living with diagnosed HIV in the US and under 10% were age ≥65. By 2035, the proportion of PLWH in this age group is projected to be 27%. Like the general population of elderly individuals, as they age, PLWH face age-related comorbidities, many of which require routine medical care and daily medications, in addition to daily antiretroviral therapy (ART) for treatment of HIV. Previous research has found that PLWH develop …

Healthcare Access Barriers In Rural America, Lakyn E. Jolly

Kentucky Journal of Undergraduate Scholarship

• In rural America, the path to accessing healthcare is met with many challenges. These challenges can present geographically and structurally within rural healthcare systems, as well as larger healthcare delivery entities. Due to these access barriers, rural Americans are at higher risk for developing poor health outcomes, as compared to their urban counterparts. Among these are higher mortality and morbidity rates, higher instances of chronic conditions, and higher rates of childhood obesity. Because rural communities are at risk for adverse health outcomes, it is vital that research and policy be geared toward reducing barriers to accessing healthcare within this population. …

Racial/Ethnic Differences In Multimorbidity Development And Chronic Disease Accumulation For Middle-Aged Adults, Ana R. Quiñones, Anda Botoseneanu, Sheila Markwardt, Corey L. Nagel, Jason T. Newsom, David A. Dorr, Heather G. Allore

Psychology Faculty Publications and Presentations

Multimorbidity–having two or more coexisting chronic conditions–is highly prevalent, costly, and disabling to older adults. Questions remain regarding chronic diseases accumulation over time and whether this differs by racial and ethnic background. Answering this knowledge gap, this study identifies differences in rates of chronic disease accumulation and multimorbidity development among non-Hispanic white, non-Hispanic black, and Hispanic study participants starting in middle-age and followed up to 16 years.

We analyzed data from the Health and Retirement Study (HRS), a biennial, ongoing, publicly- available, longitudinal nationally-representative study of middle-aged and older adults in the United States. We assessed the change in chronic …

Risk Assesment Of Air Pollution Exposure (No2, So2, Total Suspended Particulate, And Particulate Matter 10 Micron) And Smoking Habits On The Lung Function Of Bus Drivers In Palembang City, Elvi Sunarsih, Suheryanto Suheryanto, Rini Mutahar, Rahmi Garmini

Kesmas

Nitrogen dioxide (NO2), carbon monoxide (CO), sulfur dioxide (SO2), Particulate Matter (PM10) and TSP are the most common and harmful air pollutants to humans. In short period, air pollution exposure at 5 ppm for 10 minutes to humans causes dyspnea, and when the level is increase to 800 ppm could cause 100% mortality in animals. This study was an analytical research, with cross sectional design and risk analysis. One hundred subjects were analyzed in this study. The results showed that non-cancer Hazard Index (HI) for realtime exposure with mean value was NO2: 1.85; SO2: 2.92; TSP: 7.09; and PM10: 11.7 …

Obesity As Type 2 Diabetes Common Comorbidity: Study Of Type 2 Diabetes Patients’ Eating Behaviour And Other Determinants In Jakarta, Indonesia, Isna Aulia Fajarini, Ratu Ayu Dewi Sartika

Kesmas

Obesity is one of the comorbidities widely occurred among type 2 diabetes patients. It is one of the most modifiable risk factors for the prevention of other comorbid conditions such as diabetic nephropathy and cardiovascular disease. The aim of this study was to recognize eating behaviour, physical activity, and other related factors, also their correlation with obesity as comorbidity among type 2 diabetes patients. Using cross-sectional design, data were collected from purposively selected 133 members of “PROLANIS” in Jatinegara Primary Health Care, East Jakarta. Food intake was assessed by 1x24 hours food recall and FFQ, physical activity by GPAQ. The …

Post Hypertension And Stroke: A Case Control Study, Aulia Imanda, Santi Martini, Kurnia Dwi Artanti

Kesmas

The purpose of this study was to determine the factors that influence the incidence of stroke including smoking status, past hypertension , past diabetes, diet, physical activity, alcohol consumption. The design of this study is case control with a ratio of 1: 1. The total number of respondents is 132 people. Research subjects were selected using systematic random sampling. This research was conducted at Ngudi Waluyo Hospital in Wlingi. Blitar, Indonesia in October till November 2017. Bivariate analysis showed that factors significantly related to stroke were smoking status (p=0.011, OR=2.6), history of past hypertension (p=0.00, OR= 6), past diabetes (p=0.015 …

Type 2 Diabetes Patients’ Need For Physical Activity Programming: A Qualitative Study At A Yogyakarta Hospital Clini, Novita Intan Arovah, Bernadeta Wara Kushartanti, Tracy L. Washington, Kristiann C. Heesch

Kesmas

Physical activity programs offered in Indonesian hospitals are often inadequate to help type 2 diabetes (T2D) patients meet international physical activity recommendations. This study aimed to identify T2D patients’ physical activity enablers and barriers, their preferences for, and experiences with, physical activity programming, with a view to developing future programs that are suited to these patients’ needs and preferences. Four focus groups were conducted with 28 patients (50% female) of the T2D clinic at the Local General Hospital of Yogyakarta. Discussions were thematically analysed in NVivo 10. The most reported types of physical activity were walking and participation in the …

Dengue Haemorrhagic Fever And House Conditions In Kupang City, East Nusa Tenggara Province, Wanti Wanti, Ririh Yudhastuti, Hari Basuki Notobroto, Sri Subekti, Oktofianus Sila, Ragu Harming Kristina, Feby Dwirahmadi

Kesmas

Kupang City has the highest Incidence of DHF in East Nusa Tenggara and also higher than the national figure. This study aims to analyze the relationship between housing conditions and the DHF incidence in the Kupang City. This observational study uses a case-control study in 25 villages with a total sample of 500 people. Data is analyzed using t test and chi square test. The house conditions were significantly related to the DHF incidence (p≤0.05), namely house lighting, water usage, wall construction, ventilation area and ownership of clean water facilities. People are advised to ventilate the house ≥10% of the …

Risk Factor Analysis Of Overnutrition Among Elementary School Children In Pekanbaru: An Urban-Rural Perspective, Arfianti Arfianti

Kesmas

The prevalence of childhood overnutrition is increasing in many parts of the world including Indonesia. National basic health research (RISKESDAS) 2010 showed that over-nutrition in urban children (10.4%) was greater than in rural areas (8.1%). The purpose of this study was to analyse risk factors for overnutrition on elementary students in urban and rural areas in Pekanbaru. This was an observasional analytical study with cross-sectional design. This study involved 137 urban and 113 rural students from six elementary schools in Pekanbaru recruited by quota sampling technique. This study was conducted between April-May 2018. The results showed that the proportions of …

Occurrence Of Natural Vertical Transmission Of “Zika Like Virus” In Aedes Aegypti Mosquito In Jambi City, Tri Baskoro Satoto, Nur Alvira Pasca Wati, Wida Purwaningsih, Hari Kusnanto Josef, Purwono Purwono, Rumbiwati Rumbiwati, Hermanto Hermanto, Roger Frutos

Kesmas

Zika virus can be transmitted through mosquitoes such as Aedes aegypti and Ae. albopictus. During the transition period of 2014–2015, an outbreak of dengue was reported in Jambi City, during which several sufferers were screened positive for Zika virus infection by the Eijkman Institute. It was interesting to note that all of those positive for Zika virus infection were indigenous residents and none of them had a history of international travel. This descriptive analytic study with a cross-sectional design study was conducted to present an overview of Aedes spp. population using ovitrap and egg colonization methods and to detect the …

Factors Related To Adolescent Behavior Towards Hiv/Aids Prevention, Yuliasti Eka Purnamaningrum, Ratyas Ekartika Puspita Candra Nugrahawati, Munica Rita Hernayanti, Anne Vajee

Kesmas

In 2016 Special Region of Yogyakarta was ranked 9th as the province with the highest number of people suffered from HIV/AIDS especially at Sleman regency. Globally, AIDS was the second leading cause of adolescents’s death aged of 10-19 years. The purpose of this study was to find out factors affecting the behaviour of the adolescents towards HIV/AIDS prevention. This research using with cross sectional study design. The sampling technique which used was stratified random sampling resulted in 59 respondents from 11th grade students at SMA Negeri 2 Sleman were selected as sample. Data were collected using questionnaire and analyzed using …

Suicidal Thoughts, Plans, And Attempts By Non-Metropolitan And Metropolitan Residence, Kathi Harp, Tyrone F. Borders

Rural & Underserved Health Research Center Publications

Key Findings

• Mean prevalence rates for suicidal thoughts, plans, and attempts were significantly higher (P < .05) among residents of non-metropolitan than large metropolitan counties.
• The adjusted odds of suicidal thoughts, plans, and attempts did not improve significantly from 2010 to 2016 among residents of any county type.
• The study findings suggest that suicide prevention interventions should be further targeted toward non-metropolitan counties. However, new interventions may need to be specifically developed to meet the unique needs of residents in non-metropolitan counties.

Building Financial Management Capacity For Community Ownership Of Development Initiatives In Rural Zambia, Viviane Sakanga, Parker S. Chastain, Kathleen L. Mcglasson, Jeanette L. Kaiser, Misheck Bwalya, Melvin Mwansa, Kaluba Mataka, David Kalaba, Nancy Scott, Taryn Vian

Nursing and Health Professions Faculty Research and Publications

Background: Building financial management capacity is increasingly important in low- and middle-income countries to help communities take ownership of development activities. Yet, many community members lack financial knowledge and skills.

Methods: As part of a larger health intervention, we designed and conducted financial management training for 83 members from 10 community groups in rural Zambia. Change scores between pre- and post-tests on financial knowledge were calculated and multivariate linear regression models run. Qualitative feedback was elicited.

Results: The training significantly improved knowledge of financial concepts. Participants with some or more than some secondary education had greater improvements …

Prescription Opioid Use Patterns, Use Disorder Diagnoses, And Addiction Treatment Receipt After The 2014 Medicaid Expansion In Oregon, Rachel Springer, Miguel Marino, Steffani R. Bailey, Heather Angier, Jean O'Malley, Megan Hoopes, Stephan Lindner, Jennifer E. Devoe, Nathalie Huguet

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background/Aims: Evidence suggests Medicaid beneficiaries in the USA are prescribed opioids more frequently than are people who are privately‐insured, but little is known about opioid prescribing patterns among Medicaid enrollees who gained coverage via the Affordable Care Act Medicaid expansions. This study compared the prevalence of receipt of opioid prescriptions and opioid‐use‐disorder (OUD), along with time from OUD diagnosis to medication‐assisted treatment (MAT) receipt between Oregon residents who had been continuously insured by Medicaid, were newly insured after Medicaid expansion in 2014, or returned to Medicaid coverage after expansion.

Design: Cross‐sectional study using inverse‐propensity weights to adjust for …

Challenges Of Training And Delivery Of Pediatric Surgical Services In Developing Economies: A Perspective From Pakistan, Amir Humza Sohail, Muhammad Hassaan Arif Maan, Mohammed Sachal, Muhammad Soban

Medical College Documents

Background: As the pediatric population requiring health services rises globally, developing countries are struggling to cater to the growing burden of non-communicable diseases - particularly those requiring specialized surgical care.
Main body: Despite the literature supporting specialized pediatric surgical care, the developing world is far from meeting the American Pediatric Surgical Association (APSA) Manpower taskforce recommendation of at least 1 qualified pediatric surgeon per 100,000 patients (0-15 years-old). In Pakistan, there is an unmet surgical need in the pediatric population due to a multitude of short shortcomings, notably in quality and quantity of the training programs on offer, and urgent …

Redesigning Systems To Improve Teamwork And Quality For Hospitalized Patients (Reset): Study Protocol Evaluating The Effect Of Mentored Implementation To Redesign Clinical Microsystems, Kevin J. O'Leary, Julie K. Johnson, Milisa Manojlovich, Jenna D. Goldstein, Jungwha Lee, Mark V. Williams

Center for Health Services Research Faculty Publications

Background: A number of challenges impede our ability to consistently provide high quality care to patients hospitalized with medical conditions. Teams are large, team membership continually evolves, and physicians are often spread across multiple units and floors. Moreover, patients and family members are generally poorly informed and lack opportunities to partner in decision making. Prior studies have tested interventions to redesign aspects of the care delivery system for hospitalized medical patients, but the majority have evaluated the effect of a single intervention. We believe these interventions represent complementary and mutually reinforcing components of a redesigned clinical microsystem. Our specific objective …